hydroxyurea 100 MG/ML Oral Solution [Xromi]

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hydroxyurea

RxCUI: 2696079

Important: Drug coverage and costs vary by plan and location. Verify coverage directly with your Medicare plan before filling a prescription. This is informational data only and should not replace advice from your healthcare provider or pharmacist.
2.8%
Plan Coverage
142
Plans Covering
T3.7
Avg Tier
25%
Prior Auth Required

What the CMS Formulary Data Shows for hydroxyurea 100 MG/ML Oral Solution [Xromi]

Per the CMS 2026 Part D formulary file, hydroxyurea 100 MG/ML Oral Solution [Xromi] (RxNorm concept RXCUI 2696079, generic name hydroxyurea) appears on 16 distinct formulary files spanning 142 Medicare Part D plan offerings - 2.8% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 5, with a cross-plan average of Tier 3.7.

Real-world access to hydroxyurea 100 MG/ML Oral Solution [Xromi] depends on utilization management as much as tier placement: 25% of covering formularies require prior authorization. 0% require step therapy. 0% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 102,368 Part D beneficiaries filled hydroxyurea 100 MG/ML Oral Solution [Xromi] in 2023, with total plan-and-beneficiary spending of $17,214,624 and an average per-beneficiary annual cost of $168.16. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry hydroxyurea 100 MG/ML Oral Solution [Xromi] today.

Coverage Details

Formularies covering
16
Plans covering
142
Coverage rate
2.8%
Tier range
Tier 1 – Tier 5
Average tier
Tier 4, Non-Preferred

Restrictions

Prior authorization required
25% of formularies
Step therapy required
0% of formularies
Quantity limits
0% of formularies

2023 Medicare Spending

Beneficiaries
102,368
Total spending
$17,214,624
Avg per beneficiary
$168.16

Tier Distribution Across Plans

3 plans
Tier 1, Preferred Generic
1 plans
Tier 2, Generic
22 plans
Tier 4, Non-Preferred
74 plans
Tier 5, Specialty

Medicare Advantage Plans (MA-PD) Covering hydroxyurea 100 MG/ML Oral Solution [Xromi]

100 Medicare Advantage plans with Part D drug coverage include this drug.

Plan Insurer Tier PA Premium States
SeniorCare Complete (HMO D-SNP) SOUTH COUNTRY HEALTH ALLIANCE T1 No $0 MN
AbilityCare (HMO D-SNP) SOUTH COUNTRY HEALTH ALLIANCE T1 No $0 MN
Alameda Alliance Wellness (HMO D-SNP) ALAMEDA ALLIANCE FOR HEALTH T1 No $0 CA
CalOptima Health OneCare Complete (HMO D-SNP) ORANGE COUNTY HEALTH AUTHORITY T2 Yes $0 CA
Troy Medicare (HMO) TROY HEALTH, INC. T4 No $0 NC
Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) TROY HEALTH, INC. T4 No $0 NC
Contra Costa Health Care Plus (HMO D-SNP) CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH T4 No $0 CA
Keystone First VIP Choice (HMO D-SNP) VISTA HEALTH PLAN, INC. T4 No $0 PA
AmeriHealth Caritas VIP Care (HMO D-SNP) VISTA HEALTH PLAN, INC. T4 No $0 PA
First Choice VIP Care (HMO D-SNP) SELECT HEALTH OF SOUTH CAROLINA, INC. T4 No $0 SC
AmeriHealth Caritas VIP Care (HMO D-SNP) AmeriHealth Caritas VIP Next, Inc. T4 No $0 DE
AmeriHealth Caritas VIP Care Choice (HMO D-SNP) AmeriHealth Caritas VIP Next, Inc. T4 No $0 DE
AmeriHealth Caritas VIP Care (HMO D-SNP) AMERIHEALTH CARITAS FLORIDA INC T4 No $0 FL
AmeriHealth Caritas VIP Care (HMO D-SNP) AMERIHEALTH CARITAS LOUISIANA, INC. T4 No $0 LA
AmeriHealth Caritas VIP Care (HMO D-SNP) AMERIHEALTH CARITAS NORTH CAROLINA, INC. T4 No $0 NC
AmeriHealth Caritas VIP Care (HMO D-SNP) AMERIHEALTH MICHIGAN, INC. T4 No $0 MI
Health First Rewards H1099-014 (HMO) HEALTH FIRST HEALTH PLANS T4 Yes $0 FL
Health First SunSaver H1099-016 (HMO) HEALTH FIRST HEALTH PLANS T4 Yes $0 FL
Health First Complete Care H1099-023 (HMO) HEALTH FIRST HEALTH PLANS T4 Yes $0 FL
Health First Emerald Plus H1099-024 (HMO) HEALTH FIRST HEALTH PLANS T4 Yes $0 FL
Health First Premier Access H1099-025 (HMO-POS) HEALTH FIRST HEALTH PLANS T4 Yes $0 FL
Health First Emerald Plus H1099-026 (HMO) HEALTH FIRST HEALTH PLANS T4 Yes $0 FL
Health First Premier Access H1099-027 (HMO-POS) HEALTH FIRST HEALTH PLANS T4 Yes $0 FL
Health First Emerald Plus H1099-028 (HMO) HEALTH FIRST HEALTH PLANS T4 Yes $0 FL
Health First Value H1099-006 (HMO) HEALTH FIRST HEALTH PLANS T4 Yes $15.00 FL
Health First Classic H1099-001 (HMO-POS) HEALTH FIRST HEALTH PLANS T4 Yes $49.40 FL
Kaiser Permanente Senior Advantage LA, Orange Co. (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Senior Advantage Enhanced Solano (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Senior Advantage Inland Empire (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Sr Adv Enhanced Marin San Mateo (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Senior Advantage Ventura (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Senior Advantage Enhanced Kern (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Senior Advantage Basic Kern (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Senior Advantage San Diego (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Sr Adv Enhanced Santa Clara (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Senior Advantage Enhanced Stanis (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Senior Advantage Basic Stanis (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Senior Advantage Basic SnJoaq (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Senior Advantage Basic Fresno (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Sr Advantage Basic Sac., Sonoma (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Senior Advantage Santa Cruz (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Senior Advantage Basic Alameda (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Senior Advantage Basic SF (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Sr Adv Basic Contra Costa (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Sr Adv Basic Santa Clara (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Senior Advantage Basic Solano (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Senior Advantage Basic San Mateo (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Sr Advantage LA, Orange Value (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Sr Advantage Inland Empire Value (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Senior Advantage San Diego Value (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA

Frequently Asked Questions

Is hydroxyurea 100 MG/ML Oral Solution [Xromi] covered by Medicare Part D?

Yes, hydroxyurea 100 MG/ML Oral Solution [Xromi] is covered by 142 Medicare Part D plans (2.8% of all Part D formularies).

What tier is hydroxyurea 100 MG/ML Oral Solution [Xromi] on Medicare Part D plans?

hydroxyurea 100 MG/ML Oral Solution [Xromi] averages Tier 3.7 across Part D plans, ranging from Tier 1 to Tier 5.

Does hydroxyurea 100 MG/ML Oral Solution [Xromi] require prior authorization?

25% of Part D formularies require prior authorization for hydroxyurea 100 MG/ML Oral Solution [Xromi]. Step therapy: 0%. Quantity limits: 0%.

How much does Medicare spend on hydroxyurea 100 MG/ML Oral Solution [Xromi]?

In 2023, total Medicare Part D spending on hydroxyurea 100 MG/ML Oral Solution [Xromi] was $17,214,624, covering 102,368 beneficiaries. The average spend per beneficiary was $168.16.

Data sourced from the Centers for Medicare & Medicaid Services (CMS). See our methodology for details. Retrieved and formatted by PlainMedicare Editorial